Normalization of Deviance — The Pathway to Disaster
Reliability and Maintenance Bootcamp
In this session, we will discuss in detail the definition of Normalization of Deviance and how it has contributed to major accidents, including both Space Shuttle disasters. Examples will be provided of Normalization of Deviance in operating and maintaining process plants, as well as in our daily lives.
Participants will:
- Gain an understanding of how to stop Normalization of Deviance
- Learn how to identify and correct this behavior
- Take this concept home to apply with their families
Moderator:
Dean Roberts, Ergon Refining, Inc.
Speaker:
Rick Hoffman, Becht
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A First-Principles Approach to Root Cause Analysis and Human Error
Reliability and Maintenance Bootcamp
After more than 50 years of root cause analysis (RCA), you might expect problem solving to be a clear and straightforward process. It’s not. You can find yourself caught in unproductive debates. “Is that a contributing factor, or a causal factor?” “That’s a primary cause, but it’s not the main cause.” The result is frustration, inefficiency, and solutions that allow a repeat of the same problems.
A better approach to RCA is one built on evidence-based cause-and-effect relationships. The steps are simple: define the problem, explain why it happened, and identify solutions to reduce risk. Its focus is on having more reliable work processes, learning, and improving, which helps engage the frontline and minimize blame.
This session will explain the pitfalls of drifting from scientific problem solving and features a case study demonstrating how first-principles RCA leads to tangible improvements in reliability and human performance.
Participants will learn:
- Four common errors that arise when explaining why an incident occurred
- The biggest misconception about RCA
- Why effective RCA does not require any proprietary techniques, terminology, or software
- How RCA can be scaled for low-risk incidents and expanded as needed for higher-impact events.
- How to reduce “human error” by involving those who perform the work
Moderator:
Bill Clark, Phillips 66
Speakers:
Bill Clark, Phillips 66
Mark Galley, ThinkReliability
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Refinery Wastewater Upset Lessons Learned: Maintaining Production and Avoiding Negative Environmental Impacts
Environmental, Sustainability
The oil refining process generates a significant volume of wastewater that contains a suite of challenging contaminants, from hydrocarbons to heavy metals and organic compounds. Oil production at a refinery relies on efficient and reliable wastewater treatment as it is impossible for the facility to operate without treating its effluent. Issues with the wastewater treatment systems can result in production limitations, as well as significant environmental impacts and violations. These systems can be complex, and they are sensitive to upset conditions due to poor feed quality, unexpected contaminants, or equipment breakdown.
This presentation will discuss a significant upset condition that impacted both the primary and secondary wastewater treatment system at a large West Coast refinery. We will present the processes that allowed for detection of the upset, and the steps taken by the operations group, technical team, and vendor support that helped maintain target production rates and avoid any environmental violations or impacts. The mitigation steps allowed for storage and post-upset treatment of the problematic effluent streams. The technical team evaluated options for treatment and environmental compliance, and the water treatment vendor supplied specialty biological treatment technology to get the system back online as quickly as possible. All of this contributed to a successful upset response and the implementation of best practices that can help all refineries facing a wastewater oil contamination.
Moderator:
Dan Harbs, Veolia
Speakers:
Angela Wharton, Chevron U.S.A. Inc.
Kai Zhang, Chevron U.S.A. Inc.
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Topic
Capital Projects: Project Life Cycle Costs
Reliability and Maintenance Bootcamp
This session will introduce an integral part of maintenance and reliability engineers’ responsibilities to capital projects. How this relationship and communication is important to get safe, reliable, and maintainable equipment installed when working with a capital project team.
Participants will learn:
- What a project life cycle is
- What influences cost the most, and
- Industry standards for analysis
Moderator:
Bill Clark, Phillips 66
Speaker:
Dean Roberts, Ergon Refining, Inc.
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